Thread by @R_H_Ebright

GARDP/WHO report:

[T]he clinical pipeline for new antibacterials remains inadequate for current and future needs

[R]eturns on investment for new ‘reserve’ antibiotics do not cover research, development, registration, manufacturing, and distribution cost

cdn.who.int/media/docs/def…

"Antimicrobial resistance remains one of the top 10 global health threats, linked to 4.95 million deaths in 2019—surpassing those from HIV or malaria. Recent global estimates suggest that resistant bacterial infections will cause 39 million deaths by 2050."

"It also threatens the global economy…Without strengthened action, treating resistant bacterial infections alone would exert a global economic burden of USD 412B in healthcare costs and USD 443 B in lost productivity each year up to 2035"

"[O]nly 32 new antibiotics are in clinical development, but most of them derivatives of existing classes...[O]nly 12 innovative compounds are in development, with just four targeting pathogens designated as critical by WHO"

"[T]he preclinical pipeline is dynamic and innovative, but also fragile because product developers have small teams and both products and companies are subject to high turnover"

"Markets for novel antibiotics show limited viability, as returns on investment for new 'reserve' antibiotics do not cover research, development, registration, manufacturing, and distribution costs. Major pharmaceutical companies have largely abandoned antibiotic R&D"

"Due to the unfavourable and uncertain financial situation, many scientific experts continue to leave the field across all stages of development, intensifying the fragility of the R&D pipeline"

"Current incentives for antimicrobial resistance R&D are insufficient."

"'Push' incentives - government or regulatory interventions which support R&D by directly lowering the costs of development - provide a crucial lifeline to some…R&D projects but are insufficient on their own to meet R&D goals and bring new products to market."

"Pull incentives - policies rewarding R&D programs that successfully bring products to market and ensure access - have been slow to be implemented."

"There is a need for innovative financing policies. More widespread adoption of policies rewarding successful R&D programs through pull incentives or other innovative financing mechanisms are particularly necessary."

"The G7 and the EU would gain significant economic and social benefits by investing early in an multifaceted antibiotic incentive program targeting urgent public health needs."

*GARMRDH/WHO report